ORCID Profile
0000-0002-0769-7547
Current Organisations
York University
,
University Health Network
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Publisher: SAGE Publications
Date: 15-03-2018
Abstract: Ketamine research in depression has mostly used intravenous, weight-based approaches, which are difficult to translate clinically. Intranasal (IN) ketamine is a promising alternative but no controlled data has been published on the feasibility, safety and potential efficacy of repeated IN ketamine treatments. This randomised, double-blind, placebo-controlled pilot study compared a 4-week course of eight treatments of 100 mg ketamine or 4.5 mg midazolam. Each treatment was given as 10 separate IN sprays, self-administered 5 min apart. The study was stopped early due to poor tolerability after five treatment-resistant depressed participants were included. Feasibility, safety (acute and cumulative), cognitive and efficacy outcomes were assessed. Plasma ketamine and norketamine concentrations were assayed after the first treatment. Significant acute cardiovascular, psychotomimetic and neurological side effects occurred at doses 100 mg ketamine. No participants were able to self-administer all 10 ketamine sprays due to incoordination treatment time occasionally had to be extended ( min) due to acute side effects. No hepatic, cognitive or urinary changes were observed after the treatment course in either group. There was an approximately two-fold variation in ketamine and norketamine plasma concentrations between ketamine participants. At course end, one participant had remitted in each of the ketamine and midazolam groups. IN ketamine, with the drug formulation and delivery device used, was not a useful treatment approach in this study. Absorption was variable between in iduals and acute tolerability was poor, requiring prolonged treatment administration time in some in iduals. The drug formulation, the delivery device, the insufflation technique and in idual patient factors play an important role in tolerability and efficacy when using IN ketamine for TRD.
Publisher: Elsevier BV
Date: 12-2016
DOI: 10.1016/J.JAD.2016.08.002
Abstract: Prior research has shown large improvements in HRQOL after a course of ECT for depression. However, the effect of different types of ECT on HRQOL outcomes has not been explored. This is important due to the considerable range of ECT treatment modalities that currently exist in clinical practice. HRQOL data from 355 depressed patients in three Australian clinical hospitals, who received ECT given with a range of treatment modalities (combinations of pulse-width and electrode-placement), were analysed. HRQOL was measured at baseline and after ECT, using the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF). The association between type of ECT and HRQOL after ECT was examined by regression analysis, controlling for variables that may affect HRQOL outcomes. There was a significant increase in HRQOL scores after ECT (p<0.0001 t=-23.4). The magnitude of change was large (54% increase, Cohen's d=1.43). Multiple regression analysis yielded a significant model (P<0.001, R Data was collected naturalistically from clinical services, thus ECT modality was not randomly assigned. Site could have confounded results. An acute course of ECT for depression produced statistically and clinically significant improvements in HRQOL. ECT treatment modality can substantially impact HRQOL outcomes, with the possibility of bilateral ultrabrief forms of ECT being less beneficial.
Publisher: SAGE Publications
Date: 02-2019
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Adrienne Wing Yee Li.